Eleven million undocumented immigrants in the United States, including children, face barriers to health. By practicing 4 elements of sanctuary health care, clinicians and organizations can help.This painting memorializes the lives of people who died in the COVID-19 pandemic and people who have died from police brutality.Art world superstar Jean-Michel Basquiat painted the electrically vibrant, sketchy skull, Untitled, before dying of a heroin overdose at age 27. The painting's imagery and its creator's substance use struggles call to mind the victims of the current opioid epidemic. Large donations from the Sackler family, patrons of numerous museums and arts institutions, have prompted questions about art world affiliation and accountability. Largely in response to protests staged by activists such as artist Nan Goldin, numerous museums have renounced Sackler funding. What more can arts organizations consider doing amidst the crisis? The Currier Museum of Art in New Hampshire offers community support and suggests a framework for museums' roles in healing.2020 is not the only time the world has seen opioids ruining the lives of thousands. This article discusses 3 historical episodes in which the need to relieve pain was challenged by the need to prevent and control opioid addiction the era of iatrogenic addiction in the early 20th century before and after the passage of the Harrison Act of 1914; the shift in attitudes toward and treatment of pain from the 1950s to the 1970s; and the current opioid epidemic, fueled by opioid overprescription and overuse, from the late 1990s to the present. These episodes illustrate the tensions between pain relief and risk reduction and between clinical practice guidelines and modern corporate health care, as well as the stigmatization of chronic illness in American culture and society.As of 2020, North America is now into the fifth year of an unprecedented increase in drug overdose deaths driven by a toxic, unpredictable, and unregulated drug supply. While the genesis and drivers of and response to the opioid overdose crisis have wide regional variations, structural violence, prohibitions against illicit drug use, and stigma consistently play a central role. The criminalization of users of illicit drugs has led directly not only to users' incarceration, but also to their marginalization and isolation and to violence, entrenched poverty, and a vicious cycle of trauma. This policy has created an environment wherein any initiatives to prevent and reverse overdoses have been severely restricted. While a war on drugs and the people who use them has been widely criticized as destructive and unwinnable, the criminal policies that support the war on drugs have not changed even in response to this unprecedented crisis.Members of the AMA Opioid Task Force include the American Medical Association, the American Osteopathic Association, 25 specialty and state medical societies, and the American Dental Association. In 2015, the task force issued 6 recommendations focused on specific actions to help reverse the nation's opioid epidemic. https://www.selleckchem.com/products/phycocyanobilin.html Clinicians have demonstrated progress in each of these areas, and, while much work remains, making good policy will be key to motivating continued progress. Recommendations adopted in 2019 focus on tangible actions policymakers can take to help end the epidemic. This article offers an overview of task force recommendations.Pain is a universal human experience and the most common reason patients seek health care. This article describes barriers to effective, high-quality, evidence-informed pain care. Based on the clinical literature and pain specialists' survey results, the AMA Pain Care Task Force suggests strategies that clinicians can use to offer good pain care to patients. The task force also canvasses key policy-level concerns that situate clinicians in micro- and macro-level complexities related to payers, workforce and training demands, legal and regulatory questions, research, stigma, and patients' beliefs and expectations.Responding to the public health crisis in the United States resulting from untreated opioid use disorder (OUD) requires expanding delivery of effective treatments, including medications, and eliminating stigma against people with OUD and people seeking OUD treatment. Stigma discourages people with substance use disorders from seeking care and compromises the care they receive when they do seek it. Stigma against both medication treatments for OUD and harm-reduction approaches like syringe services programs has created additional barriers to these strategies' acceptance and use. It is ethically incumbent upon everyone in medicine and health care to recognize addiction not as a moral failing but as a treatable disease.The opioid epidemic challenges current attitudes toward pain management and necessitates the reexamination of the World Health Organization (WHO) 3-step analgesic ladder, introduced in 1986 for cancer pain management. Surgical treatment of pain is a logical extension of the original guideline, which is often absent in conversations with patients about treatment options for their pain and consequentially underutilized. However, with concerns growing regarding opioid use, a shift in the stepwise approach of the WHO analgesic ladder in an age of developing technology and surgical offerings could have profound implications for patients and public health. Surgical interventions potentially provide a long-term, cost-effective management strategy to reduce opioid use. This review canvasses surgical options, highlights literature on failed back surgery syndrome and spinal cord stimulation and reconsiders the current ladder approach to pain management.Research is the foundation of evidence-based health care that motivates innovations in clinical interventions and public health. Prior and current research on opioid use has focused mainly on individual patient-physician relationships, opioid use disorder and treatment, and overdose responses. This article recommends 3 priorities for future research and investigates why, from clinical and ethical standpoints, future research should be directed toward building the capacity and increasing the effectiveness of population-based programs and improving prevention strategies.